Song Xuemei, Feng Xiaoru, Chen Shuyi, Dai Yue, Huang Haoxuan, Li Xingdi, Yu Pei, Li Jia, Yi Jing, Zhao Yingying, Chen Weiyi, Ni Yuxin, Zhu Sijia, Zhang Zhihao, Xia Lu, Zhang Jia, Yang Shuaishuai, Ni Jingjing, Lu Haojie, Wang Zhen, Nie Shaofa, Wu You, Liu Li
Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
Institute for Hospital Management, Tsinghua University, Beijing 100084, PR China.
Prev Med. 2023 Oct;175:107674. doi: 10.1016/j.ypmed.2023.107674. Epub 2023 Aug 20.
Numerous studies have revealed associations between high intake of whole grains and reduced risk of various cancers. Yet, in recent decades, the traditional Chinese diets have been challenged by reduction in whole grains and increase in refined grains. To assess the impact of this dietary transition on cancer prevention, we analyzed the time trend of whole grain intake using nationally representative sampling data of over 15 thousand individuals from the China Health and Nutrition Survey. We applied the comparative risk assessment method to estimate the population attributable fraction of cancers due to insufficient whole grain intake from 1997 to 2011 and projected the trend of whole grain intake and the associated burden of cancers to 2035. We found a significant decrease of approximately 59% of whole grain intake in the Chinese population from 1997 to 2011. Compared with 1997, insufficient intake of whole grains was responsible for 9940 more cases of breast cancer, 12,903 more cases of colorectal cancer and 434 more cases of pancreatic cancer in 2011. Our projections suggest that if every Chinese would consume 125 g whole grain per day as recommended by the latest Chinese Dietary Guidelines, 0.63% bladder cancer, 8.98% breast cancer, 15.85% colorectal cancer, 3.86% esophageal cancer, 2.52% liver cancer and 2.22% pancreatic cancer (totaling 186,659 incident cases) could theoretically be averted by 2035. Even if everyone maintained the 2011 whole grain intake level, an estimated 8.38% of cancer events could still be prevented by 2035.
众多研究表明，全谷物摄入量高与多种癌症风险降低之间存在关联。然而，近几十年来，中国传统饮食受到全谷物减少和精制谷物增加的挑战。为评估这种饮食转变对癌症预防的影响，我们利用中国健康与营养调查中超过1.5万名个体的全国代表性抽样数据，分析了全谷物摄入量的时间趋势。我们应用比较风险评估方法，估计了1997年至2011年因全谷物摄入不足导致的癌症人群归因分数，并预测了到2035年全谷物摄入量趋势及相关癌症负担。我们发现，1997年至2011年中国人群全谷物摄入量显著下降了约59%。与1997年相比，2011年全谷物摄入不足导致乳腺癌病例增加9940例、结直肠癌病例增加12903例、胰腺癌病例增加434例。我们的预测表明，如果每个中国人按照最新中国膳食指南的建议每天食用125克全谷物，到2035年理论上可避免0.63%的膀胱癌、8.98%的乳腺癌、15.85%的结直肠癌、3.86%的食管癌、2.52%的肝癌和2.22%的胰腺癌（总计186659例新发病例）。即使每个人维持2011年的全谷物摄入水平，到2035年估计仍可预防8.38%的癌症事件。
